Outcome Analysis of Surgery for Blount Disease

Jones, Jerome K.; Gill, Laura; John, Mario; Goddard, Maria S.; Hambleton, Ian

doi:10.1097/bpo.0b013e3181b768d9

Cited by 21 publications

(16 citation statements)

References 18 publications

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“…This improvement was greater when patients asked to remember and rate their pre-operative status during the latest followup, revealing their level of satisfaction. This observation supports the results of the study of Jones et al that the correction of the angles measured shows a significant correlation with patient's pain score and satisfaction score [23].…”

Section: Discussionsupporting

confidence: 92%

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Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

Gkiokas

Brilakis

2012

Journal of Children's Orthopaedics

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Purpose A double osteotomy for correcting tibial deformity in combination with medial plateau elevation is recommended for the management of neglected Blount disease cases. We report our clinical experience with the application of this surgical technique and describe the longterm follow-up of the patients who were operated on. Methods During a 10-year period, eight children (8 boys) with mean age of 12 years (range 9-14 years) underwent surgery (9 operations) due to neglected infantile tibia vara. All patients suffered from stage V or VI Blount disease according to the Langenskiold and Riska classification. Two simultaneous combined osteotomies were performed for medial plateau elevation and for correction of the tibial deformity. The correction was immediate using K-wires for stabilization and a long-leg cast for immobilization. The mean duration of follow-up was 10 years (range 5-15 years), and the evaluations were based on clinical and radiological criteria. Results At the latest follow-up, there was no observable knee flexion or extension restriction and no signs of instability or lateral thrust. All patients had returned to a higher activity level. Leg-lengthening surgery was performed in one child, but the length discrepancy was already present before the double osteotomy was performed. No other complications were noticed. All the angles measured on X-rays had been corrected, and this correction was retained until the latest follow-up. Conclusions This method results in very good outcomes in patients who suffer from Blount disease of stage V or greater. With this technique, the tibial deformity is corrected, the articular surface is restored, and future recurrence is prevented.

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Section: Discussionsupporting

confidence: 92%

“…In the same article, 100 % of the patients had problems with pin-site infection. The high incidence of this complication has been confirmed by other authors [16,17,19,23]. Leg lengthening was required in one of our cases, but the discrepancy existed before the double corrective osteotomy.…”

Section: Discussionsupporting

confidence: 82%

Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

Gkiokas

Brilakis

2012

Journal of Children's Orthopaedics

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“…Standing (weight bearing) preoperative plain radiograph were taken. Lateral views and anterior--posterior views with the patella centered and pointing anteriorly were obtained as described by Jones et al [17] Langenskiold scores were measured and appropriately graded and MDA were measured with the goniometer and appropriately recorded. A standing anterior--posterior view of the knee at 6-month post surgery was assessed and MDA was also measured and recorded in degrees.…”

Section: Methodsmentioning

confidence: 99%

“…[11][12][13] Many methods have been used to evaluate surgical outcome of Blount disease. [14][15][16][17] The goal of surgery for Blount disease has been well defined but the use of postoperative MDA as an outcome measure has not been established. The aim of this study is to identify preoperative clinical and radiologic parameters that correlate with postoperative MDA grade scores in order to establish treatment goals in the settings of surgical management of Blount disease.…”

Section: Introductionmentioning

confidence: 99%

Outcome analysis of surgical treatment of Blount disease in Nigeria

et al. 2012

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“…In this study we selected children with Langenskiold stage 2 who had failed from conservative treatment. In Blount disease, recurrent deformity can still occur regardless of initially successful surgery [11,13,[16][17][18]. It is currently unknown whether overcorrection into valgus as is recommended would prevent this problem.…”

Section: Introductionmentioning

confidence: 99%

Do we need to do overcorrection in Blount’s disease?

Eamsobhana

Kaewpornsawan

Yusuwan

2014

International Orthopaedics (SICOT)

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Purpose In order to prevent recurrent deformity, overcorrection in Blount's disease has been a common practice by most paediatric orthopaedic surgeons. However, some patients have persistent valgus alignment resulting in awkward deformity. The femoro-tibial angle (FTA) was measured in this series of cases to determine the necessity of such practice. Method During 1998-2010, patients with Blount's disease stage 2 by Langenskiold, aged from 30 to 40 months who had failed from bracing and underwent valgus osteotomy were included. Seventeen legs had postoperative FTA 7-13°(group 1) and 48 legs had postoperative FTA more than 13°(group 2). ROC curve was used to determine the appropriate FTA that was suitable to prevent recurrence. Results Four legs had recurrence (28.6 %) in group 1 and six legs (12.5 %) had recurrence in group 2. Chi-square test between two groups were not statistically significant in recurrence (p = 0.434). Age and BMI were not statistically significant between recurrent and non-recurrent groups. The ROC curve shows that overcorrection more than 15°did not show benefit to prevent the recurrence in Blount's stage 2. Conclusion Our study showed that the overcorrection group had non-statistically significant recurrence compared to the non-overcorrection group, and overcorrection more than valgus 15°has no benefit to prevent recurrence.

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Outcome Analysis of Surgery for Blount Disease

Abstract: Therapeutic study, investigating the results of treatment. Level III.

Cited by 21 publications

References 18 publications

Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

Management of neglected Blount disease using double corrective tibia osteotomy and medial plateau elevation

Outcome analysis of surgical treatment of Blount disease in Nigeria

Do we need to do overcorrection in Blount’s disease?

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